Individual
MR. DALE RAY BUISMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NEONATAL NURSE PRACT
Contact information
Practice address
201 E NICOLLET BLVD, BURNSVILLE, MN 55337-5714
(952) 892-2360
Mailing address
38265 GREAT OAKS COURT, NORTH BRANCH, MN 55056-3321
(952) 892-2360
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
R1465136
MN
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
R-146513-6
MN
Other
Enumeration date
10/16/2006
Last updated
07/22/2010
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